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Tuesday, April 27, 2010

Laryngeal mask airway

Laryngeal mask was developed in 1980's, and recently is being used extensively in emergency medicine. It affords excellent ventilation without going through the normal intubation process and visualization of laryngeal inlet. It should be considered as a supraglottic airway management device. It can be introduced even by an emergency technician with training during emergency situations. Visualization of glottis is not essential for introduction of laryngeal mask airway.
Laryngeal mask was first developed by a British Anesthesiologist by name Archie Brain in 1980. Brain considered laryngeal mask airway as a physical junction between artificial and anatomic airway. According to Brain the major advantages of Laryngeal mask airway are:

1. It reduced dead space
2. Allowed normal functioning of protective reflex
3. It was highly reliable than face mask ventilation
4. It is really helpful in managing difficult airway
5. It is very useful during failed endotracheal tube intubation when the abdomen is full of inflated air. In these patients the danger of aspiration is very real. Insertion of laryngeal mask airway will not only secure the airway in these patients but also prevent aspiration of stomach contents.
6. It can be introduced even without paralyzing the patient

Development of laryngeal mask:

Brain designed laryngeal mask after careful study of plaster casts of cadaver airway. He also conceived that by inflating an elliptical cuff at the level of hypopharynx an airtight seal could be achieved. This method required reliable avoidance of down-folding of epiglottis within the mask orifice during insertion.
Laryngeal mask became commercially available in Britain in 1988, and US adopted it since 1992.